Key result
Among 100 pregnant women with heart disease, rheumatic heart disease was the most common manifestation (55%), with a 1% maternal mortality rate and 11% incidence of heart failure.
Why the study?
Heart disease in pregnancy is rising in India and carries high maternal and fetal morbidity and mortality, alongside a lack of established management guidelines.
Observational (n=100)
No
Pregnancy complicated by heart disease, predominantly rheumatic in this Indian cohort, is associated with significant maternal and fetal morbidity, highlighting the need for multidisciplinary management.
Supports multidisciplinary care in pregnant women with heart disease; leaves open need for prospective validation of risk stratification.
Background: There has been a rising incidence of pregnancy complicated by heart disease in India. The importance of heart disease in pregnancy lies in its high morbidity and mortality in both maternal and fetal outcomes combined with lack of enough established guidelines in its management.Methods: A study was done in department of obstetrics and gynaecology, KEM hospital, Mumbai from January 2016 to April 2017 retro prospectively studying the different manifestations of heart disease in pregnancy and the maternal and fetal outcomes.Results: During the study period, there were 6500 deliveries in the study center and of them 135 presented with heart disease. Of the 135 cases observed, 100 cases came under the inclusion criteria and were included in the study. The incidence of heart disease in pregnancy in the current institute is 2%. In the 100 cases, 55% were seen to have Rheumatic heart disease, 32% with cyanotic and acyanotic congenital heart disease and 13% with other conditions such as peripartum cardiomyopathy and mitral valve prolapse. Maternal outcome shows 44 patients delivered vaginally, 21 by assisted vaginal delivery and 35 required caesarean section. Maternal adverse cardiac events comprised of heart failure seen in 11 cases, ICU admissions required in 14 patients and maternal mortality in one case. Neonatal outcome comprised of 31 preterm births, still births 2, low birth weight seen in 41 and 16 needing NICU admissions.Conclusions: Early diagnosis and prompt management with a multidisciplinary approach is fundamental in managing a case of heart disease in pregnancy.
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Kambhampati et al. (2019) conducted an observational in Heart disease in pregnancy (n=100). Heart disease in pregnancy was evaluated on Maternal and fetal outcomes. Among 100 pregnant women with heart disease, rheumatic heart disease was the most common manifestation (55%), with a 1% maternal mortality rate and 11% incidence of heart failure.
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